Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis

Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis
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不同移植阶段体重指数对血液恶性肿瘤患者术后结局影响的荟萃分析

DOI:
10.1038/s41409-018-0234-1
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发表时间:
2018-05
影响因子:
4.8
通讯作者:
Wang Jing
Wang Jing
中科院分区:
医学3区
文献类型:
--
作者:
Ren Guangxu;Cai Wei;Wang Liping;Huang Jiazhang;Yi Suqin;Lu Lingang;Wang Jing

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尽管不同年龄白血病患者的体重指数(BMI)与总生存期(OS)之间的关系已有报道,但造血干细胞移植(HSCT)不同阶段的BMI水平是否对术后生存率有不同的影响仍存在争议。我们搜索了从最初到2017年7月的四个电子数据库,没有任何语言限制,并包括报告BMI时间点和HSCT的不同类型血液恶性肿瘤的研究。在确定的1420篇文章中,有26篇文章符合纳入这项荟萃分析的条件。三个体重组(肥胖、超重和体重不足)分别与正常组进行比较。使用随机或固定效应模型计算OS和无事件生存(EFS)的总体风险估计。对于HSCT前阶段的BMI,体重不足的人与正常体重的人相比,OS(RR:1.17;95%CI:1.08-1.27)和EFS(RR:1.29;95%CI:1-1.67)的风险增加有统计学意义的正相关。对于HSCT期的BMI,与正常BMI相比,较低的BMI与较差的OS(RR:1.34;95%CI:1.01-1.78)和较差的EFS(RR:1.53;95%CI:1.09-2.06)显著相关。我们的结果表明,HSCT前阶段或HSCT期间较低的BMI与较差的存活率相关。
Although the association between body mass index (BMI) and overall survival (OS) has been reported in leukemia patients of different ages, whether BMI levels at different stages of hematopoietic stem cell transplantation (HSCT) have different effects on postoperative survival remains controversial. We searched four electronic databases from inception through July 2017 without any language restrictions and included studies on different types of hematological malignancies reporting both BMI time points and HSCT. Of the 1420 articles identified, 26 articles were eligible for inclusion in this meta-analysis. Three weight groups (obese, overweight and underweight) were individually compared with the normal group. Summary risk estimates for OS and event-free survival (EFS) were calculated with random- or fixed-effects models. For BMI at the pre-HSCT stage, a statistically significant positive association of increased risk of OS (RR: 1.17; 95% CI: 1.08–1.27) and EFS (RR: 1.29; 95% CI: 1–1.67) was identified in underweight individuals compared with those with normal weights. For BMI in the HSCT stage, a lower BMI was significantly associated with poorer OS (RR: 1.34; 95% CI: 1.01–1.78) and EFS (RR: 1.53; 95% CI: 1.09–2.06) compared with a normal BMI. Our results indicated that lower BMI at the pre-HSCT stage or during HSCT is associated with poorer survival.
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发表时间: 2012-10
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